Meeting the EU’s Nutrition and Health Goals: A Business Perspective
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Transcript of Meeting the EU’s Nutrition and Health Goals: A Business Perspective
Meeting the EU’s Nutrition and Health Goals: A Business Perspective
Bas van BuijtenenDSM Nutritional Products
ELC Symposium21 November 2012, Brussels
Topics
The contribution of Fortification and Supplementation
The regulatory framework
An outlook
Example Vitamin D: In many ways an essential nutrient
Classical role of vitamin D: bone health
• Improves bone mineral density through calcium
absorption and deposition• Necessary to prevent rickets &
osteomalaciaEmerging health benefits of vitamin D Muscle: - Reduces risk of falling by
improving muscle strengthsImmunity: - Strengthens the immune system
- Reduces risk of multiple sclerosis and diabetes type IICardiovascular: - Lowers blood pressureCancer: - Inhibits cell proliferation
osteoporotic
normal
Adequacy of Vitamin D intake depends on sunshineand the diet
• Main source: Sunlight (UVB 290–
315 nm) induces vitamin D production in skin (80 – 90%)
• Minor source: Food intake of
vitamin D is scarce (10 -20%) (mainly fatty fish)
...influenced by various determinants • Sunshine exposure• Latitude > 37 / Season• Ethnicity (skin pigmentation) • Aging• Weather & air pollution• Sunlight expossure• Sunscreen use (>SPF 8)• Obesity
...further factors• Degree of clothing
(veiling)• Increase in
urbanization• Lifestyle (limited
outdoor activity)
• Alternative source: Fortification and
supplements
Worldmap Latitudes
Most of us do not get enough of it…
Vitamin D status in adults (> 18 years) around the world
The cost of Vitamin D deficiency to society is sizeable (example Germany)
Net socio-economic benefit ranges from* : 585 mio €Including medical and therapeutic costs for prevention, treatment and supplementation costs vitamin Dup to 778 mio €Including societal perspective, e.g. family care, reha costs
7 Hip and vertebral fractures have the most „cost-intense“ medical
implications • Number osteoporosis patients: 8-10
mio (2010)*• Number of hip and vertebral fractures p.a.: 150.000*Optimized vitamin-D status reduces number of
fractures by 20 %• Reduction of 5.478 hip fractures and 18.420 less vertebral
fractures (in osteoporosis-diagnosed population)
Source: * Sproll 2011
This cost / benefit increases steeply if you consider additional health indicators
Bone fractures20 %
Cardio Vascular Diseases20 %
Multiple Sclerosis50%
Diabetes
25%
Cancer and others25 %
Source: Grant et al 2009
Risk reduction by optimal vitamin status:
Large health care cost savings could be achieved with adequate vitamin D status
Source: vitamin D and socioeconomic costs, T. Sproll
Adequate levels can be achieved with voluntary food fortification and/or supplementation for risk groups with costs of only 20-30 EUR/person per year
Zittermann 2010
Germany: € 37,5 bn/y overall perspective,including direct and indirect costs and implications
Grant et al 2009
17 countries in Europe: € 187 bn/y direct and indirect cost savings (= 16,7 % of total health care costs)
Another example: Folic Acidessential for growth and development
Rich food sources are
• Liver, dark green leafy vegetables, beans, wheat germ and yeast
• Other sources are egg yolk, fortified foods e.g. fortified cereals, beets, orange juice, milk and dairy products
Food Folate (μg/100 g)
Beef liver 592Peanuts 169Spinach 145Broccoli 114Asparagus 108Egg 67Strawberries 43Orange juice (freshly squeezed)
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Wheat cereal (fortified) 200 - 400Milk (whole) 6.7(Souci, Fachmann, Kraut; whittaker 2001)
Folic acid status is directly related to the incidence of birth defect
Neural Tube Defects (NTDs)
• Congenital malformations that result from failure of the neural tube to close during embryogenesis
• Occur between twenty-two and twenty-eight days after conception, before most women know they are even pregnant
• Estimated incidence of > 300 000 new cases each
year
• Neural-tube defects, the main adverse health outcome of folate deficiency, are characterized by malformations of the spine (such as spina bifida), skull or brain (eg. anencephaly; encephalocele), and are considered to be the most common congenital malformations in the world
www.genetics.edu.au/ images/factsheets
Obicˇan, et al; FASEB J. 24, 4167–4174 (2010)Badovinas RL, Birth Defects Res Clin Mol Teratol, Vol 79, No 1, pp 8-15 (2007).
Because dietary intake is generally insufficient, many countries have introduced fortification programs
Source: Flour Fortification Initiative. Map of global progess. Available at http://www.sph.emory.edu/wheatflour/globalmap.phpThe figure above shows countries with regulations for fortification of wheat flour with folic acid, by program status, worldwide as of June 2010. A total of 53 countries had regulations for mandatory fortification of wheat flour with folic acid, although many of these programs had not been fully implemented, and the existence of regulations did not imply compliance.
In Europe, no progress towards the prevention of NTD’s in the last decadeThe consequences are financial and ethical
• Since the 1980s periconceptional folic acid supplementation is a well known instrument for primary prevention of NTDs
• No progress in Europe towards the prevention of NTDs over the last decade
The total prevalence of NTDs in Europe, between 2004 and 2008, was 0.96 per 1,000 births
The LB prevalence in Europe, between 2004 and 2008, was 0.24 per 1,000 births
72% of these pregnancies were terminated following PND
Rhonda Curran et al., Presented in Brussels 2011www.eurocat-network.eu
Germany
The Netherlands
United States
United Kingdom
Troesch et al BJN 2012
Deficiencies are everywhere. Also in the EU.Without fortification / supplementation they would be even bigger
…and there remains a huge untapped potential that innovation will uncover
Understanding the influence of genetics
Topics
The contribution of Fortification and Supplementation
The regulatory framework
An outlook
Prerequisites for a strong and innovative food ingredients sector
• Predictability through clarity• Speed in decision making• Ability to differentiate• A level playing field• Reasonable effort & cost of compliance• An opportunity to make a reasonable
return on investment
The EU regulatory framework:Opportunities and Challenges
+ Harmonisation: one large common market
+ Safety for consumers well safeguarded
+ Less misleading advertising+ Improved information and
labelling
+∆ Burdens on innovation: time
and money∆ Complexity∆ Does enforcement create a
level playing field?∆ „information“ or warning?∆ Health claims and novel food
Δ
4 year – € 4-8 mln
The regulatory framework influences ‘time-to-safety’ and ‘time-to-claim’ = time to marketFood ingredients do not offer ‘pharma’ returns. Extra efforts strongly influence the business case for innovation investment
Feasibility
Opportunity Development
Up-Scaling
Laun
ch
“Tak
e-of
f”
Turn
over
(ing
redi
ent s
ales
)
Time
4-6 year – € 5-8 mln 6 year – € 3-6 mln
Early adoption
• Product Push• Awareness
creation• Market creation
• Product Pull• Awareness
development• Fulfillment and
market development
• Meets value proposition criteria
• Solid business case
• Available for sales in pilot markets
• Justified existence• Ready for adoption
by large CPG• Proof of sustainability• Solid business case• Global roll out
€ mln
Satu
ratio
n,
“Win
ners
”
Market capturing
high
low
lowhigh
SME’s can least afford big upfront investmentBut they are the biggest engine for market innovation
Willingness to take risk
Consumer awarenessScience proof
New
Established
Small companies Large CPG companies
No sustainabl
e examples
Regional B companies, and dietary suppl. marketers
Global A companies, dietary suppl. first, then global food & beverage
Small local B&C companies, dietary suppl. marketers
Early
ado
ptio
n
Market capturing
Launch
“Tak
e-of
f”Natural flow of business
21
“The highest standard of scientific evaluation”The EFSA interpretation of the regulation pushes out time to market and increases requirements for innovation investment.
22
Labeling requirements can negate investment in safety assessment
5 versions of this product labeling were tested to measure risk perception of consumers
23Prof. Dr. Michael Siegrist – Institute for Environmental Decisions (IED)
Condition Label Additional text in the questionnaire
1 No No text
2 Yes No text
3 Yes This product contains synthetic nanoparticles and is therefore labeled
4 Yes Overall risk information of free nanoparticles (e.g., sprays) and nanoparticles in a matrix (e.g., nano sunscreen)
5 Yes Risk information about nanoparticles in a matrix (e.g., nano sunscreen)
6 Yes Information about the benefits of sunscreen
Siegrist & Keller, 2011
Even a „neutral“ nano label increased risk perception, by as much as a formal warning
24Prof. Dr. Michael Siegrist – Institute for Environmental Decisions (IED)
Condition Risk perception
No label 2.76 (SD = 1.30)n = 237
Label 3.27 (SD = 1.42)n = 224
Label and reference 3.32 (SD = 1.45)n = 222
Label and general risk information
3.19 (SD = 1.36)n = 229
Label and risk information related to a matrix
3.32 (SD = 1.44)n = 210
Label and benefit information
3.10 (SD = 1.38)n = 236
Siegrist & Keller, 2011
Topics
The contribution of Fortification and Supplementation
The regulatory framework
An outlook
Quo Vadis Europa?
How will we make Europeans healthier if we do not incentivise private sector scientific advances?
Scenario 1: marketeers focuse on products with a healthy image. Backed on science?
Supplement Marketer
“Healthy” foodstuffs:Green tea, (Super)fruits, Fish oil,
Vegetables, Gingko, Ginseng
Toller
Raw mats Ingredient supplier
Food Marketer
Consumer
Base producer
Scenario 2: public spending takes the place of private sector investment. At the same cost benefit to society?
Supplement MarketerToller
Raw mats Ingredient supplier
Food Marketer
Consumer
Base producer
Public money
Scenario 3: companies – and talented individuals – move innovation to other parts of the world
Health benefits become available to European consumers long after consumers in other parts of the world?
Our vision for Europe• Europe embraces fortification and supplementation as essential
components in a healthy lifestyle• Europe has clear regulations, where stakeholders, large or small,
understand the requirements, and can take their innovation decisions accordingly
• European procedures have well defined timelines, that do not include administrative delays, but focus on content
• Europe enforces legislation uniformly, creating a level playing field throughout the union
• European health claims legislation integrates the concept of proportionality, and allows a path to market for ‘probable’ innovations
• European labelling provides information as well as warnings, but never confuses the two
• Europe has a world class, innovative and strong food (ingredients) sector